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Continuing professional
development
The importance of non-medical health care regulators
providing “objective
and robust assurance that individual professionals remain fit to practise” is
also emphasised in the report, and this is something the Society has
been working towards for some time, Ms Neilson says. “In terms
of educating health professionals about continuing professional development — an
essential step towards revalidation — the Royal Pharmaceutical
Society is doing more than some of the other regulators, particularly
in terms of supporting pharmacists with their CPD,” she says. “The
Society has also put a lot of work into creating a culture where CPD
is integrated into pharmacists’ and technicians’ day-to-day
work,” she adds. |
The report of the “Foster review” — “The regulation
of the non-medical healthcare professions: a review by the Department
of Health” — presents a number of challenges for the Royal
Pharmaceutical Society and poses
serious questions over the future of its dual role, at least in its present form (PJ, 22 July, p91). However,
in a number of key areas it also reinforces much of what the Society
already does.
For instance, the review recommends that all regulators of non-medical
health care professions should have a “transparent and demonstrably
independent adjudicatory body on fitness-to-practise issues” — something
that, in the form of its Statutory Committee, the Society has had since
the provisions of the Pharmacy and Poisons Act of 1933 were implemented.
And it also suggests that the bodies adjudicating on fitness-to-practise
issues should have legally qualified chairmen and use a civil standard
of proof — both of which the Statutory Committee already does.
Lawyers as chairmen
Having a lawyer chairing the Statutory Committees is a strength which
the Society has had for many years and one which provides safeguards
for members of the Society. Mandie Lavin, director of fitness to practise
and legal affairs at the Society, says: “I think that any pharmacist
or technician brought before the Statutory Committee would want to
know that the person chairing the proceedings is someone of the utmost
integrity. Having a legally qualified chairman appointed by the Privy
Council means that they can be confident that is the case.” Independence
The independence of the Statutory Committee from the Society’s
Council means that, in terms of adjudicating on questions of members’ fitness
to practise, the Society is well ahead of other health care regulators,
Eileen Neilson, the Society’s head of policy development, says.
This independence also plays an important part in terms of how the Society’s
dual functions work together, Christine Gray, head of corporate governance
at the Society says. “The separation of the Statutory Committee
of the Society from its Council is important, because it means that the
people who look at individual cases are independent of those who make
policy and set standards — it is broadly similar to the separation
of parliamentarians, who make laws, from the judiciary, who adjudicate
on individual cases,” she says. “And although the Infringements
Committee is not at present independent of the Council, the new committees
being established under Section 60 to replace the Infringements Committee
and the Statutory Committee will be — members of the committees
will be appointed by the independent appointments group set up by the
Council,” Ms Gray adds.
Under the new committees, pharmacists should also feel confident that
the Society has a more appropriate range of sanctions, she says. “At
present, the Statutory Committee can only reprimand someone or take them
off the Register. Under the new system, the health committee and the
disciplinary committee will be able to suspend registration or put conditions
on it, such as requiring a pharmacist to undergo a course of treatment
for alcohol or drug misuse, to be restricted to a certain area of practice
or to be supervised for some period of time,” she adds. “I
would hope that people would see that this allows for a more sensitive,
nuanced approach to dealing with fitness-to-practise issues.” Standard of proof
The Foster review also argues that the civil standard of proof should
apply to all professional jurisdictions. A civil standard of proof
means that a case must be proven “on the balance of probabilities”,
whereas for a criminal standard of proof a case has to be proved “beyond
reasonable doubt”, Ms Lavin
explains.
“The Society’s Statutory Committee has a long history of having
a civil standard of proof, which most other regulators do not have, and
the Council is keen to retain that,” she says. “The Society’s
response to the fifth Shipman report made that clear in the response
which was fully endorsed by the Council,” she adds. “Dame
Janet Smith also made it apparent in the fifth report of the Shipman
Inquiry that she believes that the civil standard of proof has the potential
to provide greater public protection and should be the standard of proof
for all health care regulators.”
For other health care regulators, cases dealing with sexual complaints
can often fail to reach a criminal standard of proof because there may
be no witnesses, other than the complainant and the professional under
investigation, and the failure rate of such cases has caused public concern,
Ms Lavin says.
“A criminal standard of proof can also make it difficult to pursue
cases that have failed in court, even if the fact that one involves criminal
behaviour and the other professional misconduct means that the nature
of the charges is different,” she adds. “For the Society,
however, having a civil standard of proof means that if a case has not
been successfully prosecuted in court, it can still be pursued by the
Statutory Committee,” she explains.” This is particularly
the case with accusations of fraud, where there may be ample evidence
of failings in professional behaviour even if it has been difficult to
achieve a criminal conviction.” |
The
Pharmaceutical Journal